Quilt Screenings Inquiry Form - Musical Bridges Around The World

Name(Required)

First Last

Email(Required)

Phone

What type of group are you with?(Required)

School

Nonprofit Organization

Religious Group/Organization

Government Institution

Other

Name of Group(Required)

Your Position/Role(Required)

Address (Office or Screening Location Preferred)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Event(s) or Program:(Required)

Date of Event(Required)

Screening Location(Required)

Please note you will be asked to fill out a post-screening data form after you show the film (this enables us to continue providing this film for free to the community). We have a standard agreement for you to sign off on, which also includes a link to our post-screening data form. We will send this agreement to you through Adobe Sign separately.

Are you the correct person to sign this agreement?

Yes

No

I don't know yet.

Thank you for confirming.

If you are not the authorized signatory for this type of agreement, please reply with the correct information requested below of the correct person in your group/organization.

Official Signatory Name(Required)

First Last

Email(Required)

Thank you for reaching out. Please submit the form so we may start the conversation.

How did you find out about The Quilt?(Required)

Thank you for taking the time to fill out the form and for your interest in sharing The Quilt: A Living History of African American Music! We will be in touch!

Musical Bridges Around the World

Having Trouble?
Email the Marketing Director